. . . [F]or the vast majority of players, unless there is reasonable cause, the collective bargaining agreement mandates no testing for the likes of cocaine, marijuana, amphetamine, opiates (morphine and codeine) and phencyclidine (PCP) until April. Over-the-counter pain medicines, such as Tylenol or Aleve, are not tested, nor are prescription pain medicines such as Vicodin, Demerol, Percocet or OxyContin. By contrast, testing for steroids and illegal performance enhancers occurs throughout the year.

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Given that NFL players are tested for substances of abuse only during the offseason and for steroids throughout the year, while the other two “physical” pro leagues — the NBA and NHL — test for substances of abuse throughout their seasons, a cynic might infer that the NFL and NFLPA are more worried about players using steroids to get bigger and stronger than those same players using illegal drugs for treating pain or getting high.

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Relief of pain, of course, is an understandable desire for any NFL player, just as it is for any person. To expect NFL players to completely refrain from pain relief would be unreasonable and counterproductive.

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But as NFL players become bigger and stronger, and as their hits and tackles become harder and more injurious, do the NFLPA and the league have an increased responsibility to monitor pain relief? And how can the two determine if players are using painkillers to treat pain or merely to get high?

These won’t be easy questions to answer in a sport that requires physical collisions at high speeds and a league that cannot — and should not — monitor the lives of its players 24 hours a day, seven days a week. But they are important to ask because pain is a sensory response to bodily damage. If pain is muted, a person may not appreciate the damage inflicted. If that person endures the violence of NFL games week after week, not adequately comprehending bodily damage could cause serious and long-term health problems. These questions are also important to ask because NFL player contracts usually contain more non-guaranteed money than guaranteed, and NFL players are expected to “be tough” and “play hurt.” One could easily imagine them feeling pressured to use whatever it takes to stay on the field.

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Dr. James Otis, a Boston University professor of neurology and director of the Pain Management Group at Boston Medical Center, also detects a potential link worthy of more attention, especially given the narrow dates of testing for substance abuse drugs. “Persons with impaired judgment due to multiple head injuries are more susceptible to dangerous behavior, including abuse of painkillers,” said Otis. “It is very peculiar that players would only be tested for opioids during the offseason, when they would most likely use painkillers during the season.”